QualiBreath FAQ's

Generally about QualiBreath:

1. What is QualiBreath?
   QualiBreath is dual-functional external sternum and thorax support for patients that have had a sternotomy procedure e.g. heart surgery. It consists of an adjustable, chest encircling, elastic band with integrated bar handles and adjustable shoulder straps. 
   
   
2. What does dual-functional mean?
   It means QualiBreath functions in two ways. 1. it gives a constant, lateral support on the sternum by the firm, thorax encircling band, and 2. It has integrated handles to grasp by the patient to get additional circumferential chest support during coughing, sneezing and straining. 
   
   
3. Who should use QualiBreath?
   QualiBreath is strongly recommended for all patients at high risk for postoperative complications e.g. obesity, diabetes, preoperative renal failure, previous myocardial infarction, osteoporosis, age, chronic obstructive pulmonary disease (COPD),
   
   
4. Is QualiBreath only for sternotomy patients?
   No, it may help all patients who experience breathing discomfort and pain, e.g. thoracotomy and chest trauma patients. Patients with broken ribs have benefitted from using Qualibreath (see testimonies on www.qualiteam.com )
   
   
   
5. Can women use QualiBreath?
   Yes, Qualibreath is also for female patients with smaller breast sizes. Women who wear a bra with
   a cup size D or higher should wear a purpose-designed bra with integrated sternum support such as the QualiBra Advanced. The QualiBra Advanced keeps the sternal wound dry and free of breast tissue, and prevents pulling on the wound from the weight of the breast tissue while providing a constant lateral sternal support (see more on www.qualiteam.com).
   
   
   
6. Has QualiBreath been clinically proven?
   Yes. QualiBreath is the only external chest support that has been evaluated for a broad range of important criteria for postoperative recovery. It was shown to significantly decrease pain and sternal separation in patients with chronic instability, and it had a positive effect on patient function, comfort,
   [80] have shown that a firm external complementary support to the internal sternal closure significantly ease of breathing, and ease of exercise activities. Other evaluations of various external chest supports decrease sternal wound infections. 
   
   

1. What can QualiBreath do?
   

   It gives a constant lateral support on the sternum from the external side to complement the internal sternal closure, and it helps patients to manage breathing and pain after surgery in the thoracic cavity, e.g. heart, lung, esophagus operations, and any chest or rib trauma.

2. Why is lateral support on the sternum needed?
   The two sternum halves after a sternotomy are held together by wires or plates which are the only force to withstand a concurrent strain of the sternum in lateral direction. Complementing the internal sternal closure by giving lateral support on the sternum from the outside has been shown to be highly effective and to significantly decrease deep sternal wound infections.

   
   
3. Can QualiBreath give a firm support when it is elastic?
   Yes. The special selected elastic material is unidirectional and has a precisely monitored elasticity of 100+/-10%. This results in a firm, yet comfortable support all around the thorax. The controlled elasticity combined with the correct sizing and adjustable closure provides a firm, encircling thorax support without jeopardizing comfort.
   
   
4. Does QualiBreath restrict breathing?
   No. QualiBreath is designed with a calculated height of material specially not to cover the lower lung lobes or the upper abdominal area. The result is that the sternum, the thoracic wall and respiratory muscles are supported, which encourage deeper abdominal breathing and engagement of the diaphragm.
   
   
5. Can QualiBreath relieve pain?
   Yes. The firm, unidirectional, elastic support to the ribs and respiratory muscles during inspiration relieves pain and assists the patients to achieve a more relaxed, deeper breathing.
   
   
6. How can QualiBreath assist during coughing or sneezing or straining?

   

   Thanks to the bar handles which are totally integrated within the material, the patient can easily insert
   the thumbs under each of the bars and bring them together. This action will reinforce the encircling thorax support, counteract the increased thoracic internal pressure during coughing, sneezing or straining thus relieve pain and protect the sternum.

7. How can QualiBreath have any psychological effect?
   

   The constant support on thorax gives patients a feeling of being held firmly together thus reducing anxiety about potential harm to the sternal wound from coughing, sneezing, straining or breathing exercises. Qualibreath is a constant reminder for patients to protect their sternum, and the bar handles assist them to regain independence and confidence in their ability to manage themselves anytime without the need for help from hospital personnel.

8. Why is it important to use QualiBreath immediately after surgery?
   The external complementary reinforcement of the internal sternal closure helps to protect the sternum right from the start. Data on pain experience after sternotomy procedures have shown that patients have less pain when they use Qualibreath as early as possible after surgery. (Contact Qualiteam s.r.l. for details) 

How to measure and choose correct size:

1. How many sizes are available of QualiBreath?
   

   Eight adult sizes: XS, S, M, L, XL, XXL, XXXL and 4XL. Three pediatric sizes: 4-6, 6-8, 8-10 years. The XS adult size will fit 10-12 years children. Two toddler sizes: Small (chest measure 38-46 cm), and Medium (46 - 56 cm), and two infant sizes: Chest measure 27-32 cm and 32-38 cm.

2. Why is QualiBreath available in so many sizes?
   

   This is to assure the best possible fit to the patient’s thorax for an optimal, constant breathing support with optimal comfort. Each size, when correctly chosen, assures that the shoulder straps and the bar handles are positioned centrally. This is not possible with a “one-size-fits-all”.

3. Is the width of material the same for all QualiBreath sizes?
   

   All adult sizes have a width of 16 cm, pediatric sizes 10 cm, toddler 6 cm, and infant of just 3 cm.

4. How to measure for the correct QualiBreath size?
   

   The patient’s chest should be measured by placing the measure tape directly under the armpits and above the breasts - both on men, women and children to get the correct measure. Select the appropriate size on the sizing chart included on all brochures, posters and on www.qualiteam.com 

5. How much should QualiBreath be tightened?
   Since Qualibreath is placed on the patient immediately after surgery, often before he/she is fully awake after the anesthesia, we recommend to start with a lighter closure at the first Velcro attachment. When the patient is awake and cooperative, it can be tightened more towards the most inner Velcro position to achieve a tighter and firmer support.
   
   
6. What can be done if QualiBreath is closed at the innermost Velcro but does not give enough support to the patient?

   In this case a too large QualiBreath size has been chosen - a solution can be to attach the Velcro closure directly on the blue material for a tighter fit while ensuring the bar handles still have the sternum centrally between them. If the shoulder straps thereby get into a too distorted position to cause discomfort, we recommend to choose a new, correct size.
   
   
7. Is there a way to chose a Qualibreath size if no measure tape is at hand? 
   

   Yes, a rough method is to use the patient’s normal clothing or T-shirt size as a guide, e.g. Small, Medium etc. Another rough way is to use one’s hands to measure the patient’s thorax from one armpit to the other above the breasts. An outspread hand-width from thumb to little-finger is about 20 cm or 8 inches e.g. if the measure is 2.5 hand-widths, the chest measure would be 5 hand-widths, or 100 cm (40 inches).

How to use QualiBreath:

1. When should QualiBreath be placed on the patient?
   QualiBreath should be applied in the operating room immediately after surgery by placing it on the bed before the patient is transferred. Using this practice is undemanding for staff and less challenging for the patient.
   
   
2. How should QualiBreath be used, under or over the patient's clothes?
   QualiBreath is designed to be used directly on the patients’ skin. It can be used over the clothes, however, care should be taken that there are no folds between QualiBreath and the clothing which could irritate the patients’ skin.
   
   
3. What is the correct position of QualiBreath?
   QualiBreath must be positioned as high as possible at the front of the chest. It should also be as high as possible at the back side without causing irritation underneath the armpits. The shoulder straps can be adjusted for achieving the correct position.
   
   
   
4. Why is there no underarm shaping on QualiBreath?
   Cutting out an area in the QualiBreath band under the armpits would eliminate the important encircling tension efficiency and the lateral support of the sternum corresponding to the depth of an underarm shaping.
   
   
5. What to do if patients feel QualiBreath bothers them under the arms?
   This may happen specially when patients are bedridden more than expected which can cause QualiBreath to be pushed up at the back side. If the shoulder straps are crossed at the back side, uncross and readjust them for a lower position at the back. Eventually use the Axilla perspiration pads accessory to protect the armpits.
   
   
6. Can the patient place the QualiBreath on their own?
   Not immediately after surgery. QualiBreath should initially be applied by a health care professional in the OR or in the ICU. When patients are active and have learnt the correct arm movements for protection of their sternum, they can easily position QualiBreath without help.
   
   
7. How does the QualiBreath handles work?
   The handles should be used by both hands while the upper arms are kept close to the chest. The patient places each thumb under the material fold that contains the bar handle at both sides of the sternum. He/ she then places the other fingers behind the bar handle on the opposite side and simply closes both hands as a fist. This action brings the two bar handles together paralleled, which stretches the elastic band at its full height, add extra encircling support to the chest and increases lateral reinforcement on the sternum.
   
   
8. When should patients use the handles?

   The handles should be grasped for additional support during coughing, sneezing or straining. It is also helpful during deep breathing exercises or other painful situations.
   
   
9. How can the bar handles be used when QualiBreath is worn under the clothes?
   The handles are easily grasped through most materials used for shirts,
   T-shirts or blouses. It is usually not necessary to wear an open shirt
   – QualiBreath can be completely hidden and used discreetly under
   the patient’s clothes.
   
   
10. Is the distance between the handles the same in all sizes?
    

    No, the distance becomes proportionally larger, the larger the size of QualiBreath.

11.  How can drainage tubes be accommodated with QualiBreath?
    

    Normally the drainage tubes exit below the lower elastic margin of QualiBreath. Depending on a patient’s build and figure, the drains may exit without difficulties underneath the elastic material.

    
    
12. Can QualiBreath be used in bed?
    Yes, it is designed to be used comfortably directly on patients’ skin under their clothes, in or out of bed.
    
    
13. Should QualiBreath be used during the day or at night only?
    QualiBreath should be used both day and night for as long as the sternum bone is healed, which means at least 8 weeks.
    
    
14. Is QualiBreath warm to use for the patient?
    No. The special chosen material is ventilated - for every horizontal line of 7 mm material there is 3 mm line of open space for the skin to “breathe".
    
    
15. Some patients perspire excessively. Does Qualibreath increase perspiration?

    No. Normally not since the QualiBreath material is ventilated. Patients with excessive perspiration under the armpits may want to use the accessory, Axilla perspiration pads which easily can be exchanged for washing as needed.
    
    
16. Can the QualiBreath cause irritation to the skin?
    Most unlikely. All seams are on the outside of the material facing away from the patient’s skin including the manufacturer’s labels, and the bar handles are totally integrated inside the material. Furthermore there are no buckles or other rigid items to cause pressure points on the skin.
    
    
17. Can the QualiBreath elastic material cause any allergic reaction?
    Most unlikely. The QualiBreath material is free of natural rubber (NRL) also called Latex-free.
    
    
18. Is QualiBreath washable?
    

    Yes. For longevity of the elastic material we recommend to wash it at 30°C/86°F without tumble drying. It is possible to wash QualiBreath at 60°C/140°F, but should not be done more than 3 times, since the elasticity will loose some strength at each wash – as any other elastic material.

    
    
19. Should QualiBreath only be used during the stay in the hospital?
    No. QualiBreath is a “one-per-patient” product and should follow the patient who needs to use it for 8 weeks or more at home.

QualiBreath and other devices:

1. What are the advantages of QualiBreath compared to other chest support products?
   QualiBreath is the only dual-functional external chest support. It gives the patient’s sternum support all the time 24/7, and the integrated bar handles are a self-help tool for managing the situations with extra pain a patient may experience during coughing, sneezing, straining, deep breathing exercises, or simply when moving around. Other chest supports have only one function: they are either a continuous chest support, or they are a cough support. No other devices combines both functions in one device..
   
   
2. Is using a pillow an alternative to QualiBreath?
   No. A pillow can not constantly support the sternum. Traditionally patients have often been advised to press a pillow against the sternum when coughing or sneezing. However, pressing a pillow or any other device directly inward on a fresh sternum wound and bone can do more harm than good, and may be a source of infection since pillows often fall on the floor or get in contact with other potential infection sources..